Download PDF
Thromb Haemost 1998; 79(05): 928-931
DOI: 10.1055/s-0037-1615096
Review Article
Schattauer GmbH

Failure of Thrombolytic Therapy in Patients with Myocardial Infarction Is Associated with High Plasma Levels of Factor VII Antigen

Johan Holm
1   From the Department of Cardiology, Malmö, Sweden
,
Tim Tödt
1   From the Department of Cardiology, Malmö, Sweden
,
Erik Berntorp
2   From the Department for Coagulation Disorders, Malmö University Hospital, Malmö, Sweden
,
Leif Erhardt
1   From the Department of Cardiology, Malmö, Sweden
› Author Affiliations
Further Information

Publication History

Received 20 June 1997

Accepted after resubmission 16 January 1998

Publication Date:
07 December 2017 (online)

    Permissions and Reprints

Summary

Thrombolytic therapy in acute myocardial infarction fails to re-establish coronary blood flow in a significant number of patients. One reason for this may be haemostatic imbalance. We investigated whether coagulation factor VII antigen (FVIIag), fibrinogen and protein C were related to reperfusion. Plasma from 45 patients was drawn before treatment and reperfusion assessed by means of continuous, on-line, vector-ECG analysis.

Amongthe 17 patients with no reperfusion, FVIIag levels were significantly higher than among the 28 with signs of reperfusion (560 vs. 410 μg/l median, p = 0.006). Protein C levels where higher in the group with successful reperfusion (1.10 vs. 1.01 U/ml median, p = 0.03), whereas no difference was seen in fibrinogen levels. The findings were not influenced by plasma-triglycerides, body-mass index, age or time between onset of chest pain and thrombolytic therapy.

The results suggest that FVII is of importance for the formation as well as resolution of coronary clots.

 

  • References

  • 1 The TIMI Study Group.. The thrombolysis in myocardial infarction (TIMI) trial. N Engl J Med 1985; 312: 932-6.
    PubMedGoogle Scholar
  • 2 The GUSTO Angiographic Investigators.. The effect of tissue plasminogen activator, streptokinase, or both on coronary artery parency, ventricular function and survival after acute myocardial infarction. N Engl J Med 1993; 329: 1615-22.
    CrossrefPubMedGoogle Scholar
  • 3 Bode C, Runge MS, Smalling RW. The future of thrombolysis in the treatment of acute myocardial infarction. Eur Heart J 1996; 17 (supplement E): 55-60.
    CrossrefPubMedGoogle Scholar
  • 4 Pasceri V, Andreotti F, Maseri A. Clinical markers of thrombolytic success. Eur Heart J 1996; 17: 35-41.
    PubMedGoogle Scholar
  • 5 Dahlbäck B, Hildebrand B. Inherited resistance to activated protein C is corrected by anticoagulant cofactor activity found to be a property of factor V. Proc Natl Acad Sci USA 1994; 81: 1396-400.
    PubMedGoogle Scholar
  • 6 Dellborg M, Topol E, Swedberg K. Dynamic QRS complex and ST segment vector-cardiographic monitoring can identify vessel patency in patients with acute myocardial infarction treated with reperfusion therapy. Am Heart J 1991; 122: 943-8.
    CrossrefPubMedGoogle Scholar
  • 7 Dellborg M, Steg PG, Simoons M, Dietz R, Sens S, van den Brandt M, Lotze E, Hauck S, van den Wieken R, Himbert D, Svensson A-M, Swedberg K. Vector-cardiographic monitoring to assess early vessel patency after reperfusion therapy for acute myocardial infarction. Eur Heart J 1995; 16: 21-9.
    PubMedGoogle Scholar
  • 8 Klootwijk P, Langer A, Meij S, Green C, Veldkamp RF, Ross AM, Armstrong PW, Simoons ML. Non-invasive prediction of reperfusion and coronary artery patency by continuous ST segment monitoring in the GUSTO-I trial. Eur Heart J 1996; 17: 689-98.
    CrossrefPubMedGoogle Scholar
  • 9 Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, North WRS, Haines AP, Stirling Y, Imeson JD, Thompson SG. Haemostatic function and ischemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986; 2: 533-7.
    PubMedGoogle Scholar
  • 10 Thompson SG, Kienast J, Pyke SDM, Haverkate F, van de Loo JCW. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Engl J Med 1995; 332 (10) 635-41.
    CrossrefPubMedGoogle Scholar
  • 11 Hamsten A. Hemostatic function and coronary artery disease. N Engl J Med 1995; 332 (10) 677-8.
    CrossrefPubMedGoogle Scholar
  • 12 Heinrich J, Balleisen L, Schulte H, Assmann G, van de Loo J. Fibrinogen and factor VII in the prediction of coronary risk. Result from the PROCAM study in healthy men. Arterioscler Thromb 1994; 14: 54-9.
    CrossrefPubMedGoogle Scholar
  • 13 Fuster V, Fallon JT, Nemerson Y. Coronary thrombosis. Lancet 1996; 348 (Suppl I): s7-s10.
    PubMedGoogle Scholar
  • 14 Petersen LC, Valentin S, Hedner U. Regulation of the extrinsic pathway system in health and disease: the role of factor VIIa and tissue factor pathway inhibitor. Thromb Res 1995; 79 (01) 1-47.
    CrossrefPubMedGoogle Scholar
  • 15 Ruddock V, Meade TW. Factor VII activity and ischaemic heart disease: fatal and non-fatal events. QJMed 1994; 87: 403-6.
    PubMedGoogle Scholar
  • 16 Abendschein DR. Potential advantages of novel antithrombotic agents administered conjunctively during coronary fibrinolysis. Coronary Artery Dis 1996; 7: 522-7.
    CrossrefPubMedGoogle Scholar
  • 17 Ragni M, Cirillo P, Pascucci M, Scognamiglio A, D’Andrea D, Eramo N, Ezekowitz MD, Pawashe AB, Chiariello M, Golino P. Monoclonal antibody against tissue factor shortens tissue plasminogen activator lysis time and prevents reocclusion in a rabbit model of carotid artery thrombosis. Circulation 1996; 93: 1913-8.
    CrossrefPubMedGoogle Scholar
  • 18 Mennen LI, Schouten EG, Grobbee DE, Kluft C. Coagulation factor VII, dietary fat and blood lipids: A review. Thromb Haemost 1996; 76 (04) 492-9.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Moor E, Silveira A, van’t Hooft F, Suotaka AM, Eriksson P, Blombäck M, Hamsten A. Coagulation factor VII mass and activity in young men with myocardial infarction at a young age. Arterioscler Thromb Vasc Biol 1995; 15: 655-64.
    CrossrefPubMedGoogle Scholar
  • 20 Merlini PA, Ardissimo D, Oltrona L, Broccolino M, Coppola R, Mannucci PM. Heightened thrombin formation but normal plasma levels of activated factor VII in patients with acute coronary syndromes. Arterioscler Thromb Vasc Biol 1995; 15: 1675-79.
    CrossrefPubMedGoogle Scholar
  • 21 Hoffman CJ, Miller RH, Hultin MB. Correlation of factor VII activity and antigen with cholesterol and triglycerides in healthy young adults. Arterioscler Thromb 1992; 12: 267-70.
    CrossrefPubMedGoogle Scholar
  • 22 Saikku P, Leinonen M, Mattila K. Serological evidence of an association of novel chlamydia, twar, with chronic coronary heart disease and myocardial infarction. Lancet 1988; 2: 983-6.
    PubMedGoogle Scholar
  • 23 Gruber A, Pal A, Kiss RG, Sas G, Griffin JH. Generation of activated protein C during thrombolysis. Lancet 1993; 342: 1275-6.
    CrossrefPubMedGoogle Scholar
  • 24 Schröder R, Wegscheider K, Schröder K, Dissmann R, Meyer-Sabellek W. for the INJECT-Trial-Group. Extent of early ST segment elevation resolution: A strong predictor of outcome in patients with acute myocardial infarction and a sensitive measure to compare thrombolytic regimens. J Am Coll Cardiol 1995; 26 (07) 1657-64.
    CrossrefPubMedGoogle Scholar
  • 25 Lundin P, Eriksson SV, Strandberg LE, Rehnqvist N. Prognostic information from on-line vector cardiography in acute myocardial infarction. Am J Cardiol 1994; 74: 1103-8.
    CrossrefPubMedGoogle Scholar
  • 26 Purcell IF, Newall N, Farrer M. Change in ST segment elevation 60 minutes after thrombolytic initiation predicts clinical outcome as accurately as later electrocardiographic changes. Heart 1997; 78: 465-71.
    CrossrefPubMedGoogle Scholar